Tenant filing insurance claim for accident which didn't happen

7 Replies

I have a tenant who rents a Single home and refused to heat the home during the winter.  He would use heat in only the bedrooms.  Pipes froze and burst in kitchen,  Plumber repaired the problem.  i told tenant he would need to pay for repairs because his negligence.  About 2 weeks after repair a 2 foot by 2 foot section of plaster fell in kitchen.  Tenants wife told me they were upstairs and heard the noise.  After all repairs were made in ceiling I received a letter from an attorney representing him.

1. He never was hit because he was upstairs when plaster fell

2. He was negligent in not using heat

3. Clear insurance fraud

4.  I have not responded to the attorney

I assume he will move out soon because month to month lease.

Anyone experience similar situations?  I don't plan on informing my insurance unless I get served with court papers.  Do state insurance fraud departments get involved in these situations?  Any suggestions? Thanks

It may be in your best interest to immediately turn the entire matter over to your insurance company.

@Kevin Donovan  this doesn't fall into the "ignore it and it will go away" category.  Turn it over to your insurance company. Let them investigate.  Defense costs are covered by your liability policy.  

No legal advice.

I had one tenants dog bite another tenant two separate houses I just happen to own both. Broke the skin but not a bad. got letter from attorney wanting my insurance. My attorney said he's just looking for a quick 2k settlement from insurance and then your insurance will double. I ignored it he eventually filed a boiler plate law suit I personally answered complaint because it was obviously a frivolous suit. When he sent interrogatories I answered honestly it asked about my insurance I just answered I don't have any insurance that covers dog bites. A few months latter he dropped suit.

@Kevin,   Here is a big help of advice, I'm a Full time Insurance adjuster with a  large national carrier (well known), wholesale Investor and investor of 24 rentals.

1st), I need to state this is 100% Fraud, I would NOT pay the claim if I was the one to get the case as an adjuster, as everyone knows we do carry a book of checks to write to homeowner on site. Let me state this thou, not sure what insurance company you have for property, a small claim like this may be handled over the phone.

2nd), IT IS the tenant's responsibility to keep the heat on in the house during cold season, "IF" the house was "Vacant" THEN and only THEN it would be YOUR responsibility to keep house at a decent temp so the pipes do not freeze, "IF" you the property owner had no heat on in house during cold winter and the pipes busted, we still DO NOT have to pay the claim because of the lack of responsibility of homeowner.

3rd), Even if the 2x2 small piece of drywall fell on tenant from ceiling, that is not going to hurt anyone, IF, say fell on him, is there a hospital bill?

I tell everyone, same as your agent would tell you, you should not file a claim for under $2,500, knowing your rate will increase the following renewal time, will also be on state insurance claim records for 5 years which follows property, Not you.   

What is he trying to gain here?

Personally I would recommend as an Insurance Adjuster since he got an attorney, file a Insurance fraud claim with your state, file a counter claim against tenant for NOT heating house and causing damage, Normally I know in most states you can make the tenant pay for ALL damages, also HOW does your Lease read?, I see you stated month to month, but I would hope that at some point he signed a lease, IF he did not sign a lease, WHY is he there.

BUT this is NO legal advice, just a full time adjustor       

Thanks for all the advice.  It is very helpful.

Here are some more details.  Insurance - State Farm. Tenant never told me he was hurt and still has never had a discussion about being hit by plaster ceiling.  The only reason I know is the attorney letter.  His yearly lease ends April 30 2015 then becomes month to month so I assume he is moving because plumber told me boxes are packed.

I have no idea if there is a hospital bill.  I will assume he does have a bill.

He is trying to gain a quick settlement and move on to the next landlord.

I plan on making him pay for the damage.  I notified him of this and this is probably the reason he got an attorney.  I will file civil action if he doesn't pay for the damage.

Here are my questions:  Should I file insurance fraud with the state now or wait until he vacates probably in May 2015?    Should I file insurance fraud now or wait until I am actually served with court paperwork?

Tim, you mentioned a small claim can be handled over the phone.  If it is a small claim under $2500 and I report it my rates will increase.  If I report it to my insurance company they take control of the case and might just pay it off to get it off the books.   My rates than increase.  I was going to delay reporting it to my insurance company until they either serve me with the court paperwork or the attorney pressure increases.   I don't want to make this easy for them so this is why I am not responding. 


I am an adjuster for that company you mentioned. We always recommend if the claim is $2500 or under you should take it out of your pocket, not turn it into a claim,  if the claim is $2800 you will pay that amount back plus a few hundred more over a five year period.

Not sure what kind of pain the tenant would experience with a small piece of drywall falling on his or her head, Personally I would question it, understand we have the right to refuse to pay a claim, sure the attorney could file lawsuit against State Farm, where would it go, not far, would never go to court because it would be turned over to the fraud department inside State Farm, this would be held against you, not the tenant since you are the policy holder.

The tenant is trying to gain some quick cash.

You stated you are planning on making the tenant pay for damages, the tenant does NOT have to pay any invoice you send him unless you had it in writing in your lease, which I'm it's in there.

Here in my area, we have to file a small claims suit, cost is 65.00 if I recall it's 90.00 in Pennsylvania, at the court hearing your presenting your case and what had happen to the pipes, ceiling and whatever else PLUS add in the fact of any damage that you will have to repair after the tenant moves out, of course you will keep the deposit money.

Steps I recommend taking in this order starting tomorrow:  Look at all your expenses to repair pipes, drywall paint whatever else there was or is going to be.

File a small claim in small claims court, stated above under 100. file for damages, present your claim, then the tenant will be allowed to talk to judge, upon doing so if tenant does not mention it the judge will probably ask why did pipes freeze if your living in the house? tenants response will probably be we had the heat off to save money, You just won the case right there, I have been in court probably 50 times in last ten years, I've won every time with claims and evictions.  

IF he is planning on moving has he given you a 30 day notice? if not you can go after another months rent, or you have, (my best choice) is send a certified letter to tenants stating you are NOT going to renew their lease when it ends April 30th 2015, if none of this has taken place, Get on it, send the letter tomorrow as Tenants have 30 days by law.

The tenant DOES NOT control your insurance only you do, NO tenant can file a insurance claim, if your tenant was somehow able to file a fraud claim, that can be a police criminal case.

Questions I would have are: Was there bad drywall on ceiling in order for it to fall? did the pipes freeze because of the tenants not having heat on?  (A side note, when you rent, don't care to who, taken photos of interior, all rooms, I do before they move in 99% of time while they, the tenants are there so they see me taking photos and they can point anything out they want to me, helps me big time and sucks for them saying this or that when they move out and want deposit back, when maybe the walls need re-painted, carpet needs replaced, you get the point.) I charge for everything, repainting walls, carpets cleaned, etc.

Wish I could see that attorney letter, I would be more then happy to help you respond to it in writing.

In My opinion this is NOT a insurance or an attorney case, it's a basic tenant trying to gain a personal benefit from you, thinking we as investors have tons of money.

Attorney claims you stated 2000. NOW you have to deduct the cost of repair, it's the tenant fault that the pipes froze, I take it, not yours. so NO there is NO attorney case, the tenant has feed the attorney a bunch of BS in order for him to take the case.

Sorry to have this so long, trying to explain everything here in steps.

Tim Mitchell

[email protected]


Talk to insurance company, their attorney, asap. Don't post details here, could be used against you

Additionally, sue them for causing damage to pipes by not turning heat on.

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